Varwere vazhinji vane kenza yechiropa vasingakodzeri kuvhiyiwa kana mamwe marapirwo vane sarudzo.
Ongororo yeNyaya
Nyaya 1 yeKurapa Kenza yeChiropa:
Murwere: Murume, kenza yechiropa chikuru
Kurapa kekutanga kweHIFU kwegomarara rechiropa pasi rose, kwakararama kwemakore gumi nemaviri.
Nyaya Yechipiri Yekurapwa Kwekenza Yechiropa:
Murwere: Murume, ane makore makumi mashanu nemaviri ekuberekwa, kenza yechiropa chikuru
Mushure mekubviswa kwemasero eropa ne radiofrequency, bundu rakasara rakaonekwa (bundu riri pedyo ne inferior vena cava). Mushure mekurapwa kwechipiri kweHIFU, kubviswa kwebundu rasara kwakaitwa, nekuchengetedzwa kwakakwana kwe inferior vena cava.
Nyaya Yechitatu Yekurapwa Kwekenza Yechiropa:
Kenza yechiropa yekutanga
Kutevera mushure memavhiki maviri ekurapwa neHIFU kwakaratidza kuti bundu racho rakanyangarika zvachose!
Nyaya yeKurapa Kenza yeChiropa 4:
Murwere: Murume, ane makore 33 ekuberekwa, kenza yechiropa yakapararira
Chironda chimwe chete chakawanikwa muchikamu chimwe nechimwe chechiropa. Kurapwa kweHIFU kwakaitwa panguva imwe chete, zvikaita kuti bundu riparare uye rinyure mumuviri kwemwedzi mitatu mushure mekuvhiyiwa.
Nyaya 5 yeKurapa Kenza yeChiropa:
Murwere: Murume, ane makore makumi manomwe ekuberekwa, kenza yechiropa
Bundu rakasara rakaonekwa paMRI mushure mekuiswa kweiodine oil mushure mekuiswa kweropa muropa. Kuwedzera kwemavara kwakanyangarika mushure mekurapwa neHIFU, zvichiratidza kubviswa kwebundu zvachose.
Nyaya 6 yeKurapa Kenza yeChiropa:
Murwere: Mukadzi, ane makore makumi manomwe ekuberekwa, kenza yechiropa chikuru
Bundu retsinga dzeropa rakanyanya kureba 120mm* 100mm yakawanikwa muchikamu chekurudyi chechiropa. Kubviswa kwebundu kwakaitwa mushure mekurapwa neHIFU, zvishoma nezvishoma kwakapinda nekufamba kwenguva.
Nyaya 7 yeKurapa Kenza yeChiropa:
Murwere: Murume, ane makore 62 ekuberekwa, kenza yechiropa chikuru
Ronda riri padyo nedenga re diaphragmatic, inferior vena cava, uye portal vein system. Mushure mezvikamu zvishanu zve radiofrequency uye zvikamu zviviri zveTACE, bundu rakasara rakaonekwa paMRI yekutevera. Kurapwa kweHIFU kwakabudirira kudzima bundu uku kuchichengetedza tsinga dzeropa dzakaripoteredza.
Nyaya 8 yeKurapa Kenza yeChiropa:
Murwere: Murume, ane makore 58 ekuberekwa, kenza yechiropa chikuru
Kudzoka kwegomarara rechiropa rakaonekwa mushure mekuvhiyiwa kwegomarara rechiropa rerudyi. Kubviswa kwegomarara kwakazara kwakaitwa nekurapwa neHIFU, kwakasimbiswa nekunyudzwa kwegomarara mushure memwedzi 18.
Hyperthermia yeCancer yeChiropa - Tsvagiridzo Yakarongeka
HIFU (High Intensity Focused Ultrasound) inogona kushandiswa kurapa kenza yechiropa. Nzira dzekurapa dzechinyakare dzekenza yechiropa dzinosanganisira kuvhiyiwa, transarterial embolization, uye chemotherapy. Zvisinei, varwere vazhinji vanoonekwa vari padanho repamusoro kana kuti vane bundu riri pedyo netsinga huru dzeropa, zvichiita kuti kuvhiyiwa kusashande. Pamusoro pezvo, vamwe varwere havagone kuvhiyiwa nekuda kwemamiriro avo emuviri, uye kuvhiyiwa pachako kune njodzi yematambudziko.
Kurapa kenza yechiropa neHIFU kune zvakanakira zvakawanda:Hazvinyanyi kukuvadza, hazvinyanyi kukonzera marwadzo nekukuvadzwa, hazvina njodzi, hazvina matambudziko akawanda, uye zvinogona kudzokororwa kana zvichidikanwa. Zvinogona kuvandudza zviratidzo zvemurwere uye kuwedzera nguva yekurarama kwake.
Mushure mekurapwa neHIFU, hapana nyaya dzekuputika kwebundu, jaundice, kubuda kwenyongo, kana kukuvara kwetsinga dzeropa dzakataurwa, zvichiratidza kuti kurapwa kwakachengeteka.
(1) Zviratidzo:Kurapa kwekuderedza kurwara kwegomarara repamusoro, kenza yechiropa yega iri pamucheto wekurudyi ine dhayamita iri pasi pe10cm, magomarara makuru pamucheto wekurudyi ane maronda esatellite anoramba akavharirwa pachiropa chekurudyi, kudzoka kwenzvimbo mushure mekuvhiyiwa, thrombus ye portal vein tumor.
(2) Zvinorambidzwa:Varwere vane cachexia, kenza yechiropa inopararira, chiropa chisina kushanda zvakanaka panguva yekupedzisira, uye metastasis iri kure.
(3) Maitiro ekurapa:Varwere vane bundu riri kurudyi vanofanira kurara nerutivi rwavo rwerudyi, ukuwo avo vane bundu riri kuruboshwe vanowanzoiswa vakarara vakarara. Pamberi pekurapwa, ultrasound inoshandiswa kuwana bundu kuti rinyatsoongororwa uye kurongwa kwekurapwa. Bundu rinozorapwa kuburikidza nekubvisa bundu zvakatevedzana, kutanga kubva panzvimbo imwe neimwe uye kufambira mberi kusvika kumiganhu, nzvimbo, uye pakupedzisira huwandu hwebundu rose. Kurapa kunowanzoitwa kamwe chete pazuva, nechikamu chimwe nechimwe chinotora maminetsi angangoita 40-60. Maitiro acho anoenderera mberi zuva nezuva, chikamu nechikamu, kusvika bundu rese rabviswa. Mushure mekurapwa, nzvimbo yakarapwa inoongororwa kuti hapana kukuvara kweganda, zvichiteverwa ne ultrasound scan yenzvimbo yese yakatarwa kuti ione kushanda kwekurapa.
(4) Kutarisirwa mushure mekurapwa:Varwere vanoongororwa mashandiro echiropa uye mazinga eelectrolyte. Kurapa kunotsigira kunofanira kupihwa kune varwere vane mashandiro asina kunaka echiropa, ascites, kana jaundice. Varwere vazhinji vane tembiricha yemuviri yakajairika panguva yekurapwa. Nhamba shoma yevarwere inogona kuwedzera tembiricha mukati memazuva 3-5, kazhinji pasi pe38.5℃. Kutsanya kunowanzo kurudzirwa kwemaawa mana mushure mekurapwa, nepo varwere vane kenza yechiropa yeruboshwe vanofanira kutsanya kwemaawa matanhatu vasati vachinja zvishoma nezvishoma kuenda kukudya kwemvura. Vamwe varwere vanogona kurwadziwa zvishoma mudumbu kwemazuva 3-5 mushure mekurapwa, izvo zvinopera zvishoma nezvishoma.
(5) Kuongorora kushanda zvakanaka:HIFU inogona kuparadza tishu yekenza yechiropa, zvichikonzera kupararira kwemasero ekenza. Kuongororwa kweCT kunoratidza kudzikira kukuru kweCT attenuation values munzvimbo dzakatarwa, uye CT inosimbiswa necontrast inosimbisa kusavapo kweropa remutsinga neremutsinga kunzvimbo yakatarwa. Bandi rekuwedzera rinogona kuonekwa pamucheto wekurapa. MRI inoona shanduko mukusimba kwechiratidzo chebundu pamifananidzo yeT1 neT2 uye inoratidza kunyangarika kweropa kunzvimbo yakatarwa muzvikamu zveropa neremutsinga, nechikamu chinononoka chinoratidza bandi rekuwedzera pamucheto wekurapa. Kuongororwa kweUltrasound kunoratidza kudzikira zvishoma nezvishoma kwehukuru hwebundu, kunyangarika kweropa, uye kunyangarika kwematishu kunozopedzisira kwanyura.
(6) Kutevera:Mumakore maviri ekutanga mushure mekurapwa, varwere vanofanira kushanyirwa mwedzi miviri yega yega. Mushure memakore maviri, kushanyirwa kunofanira kuitwa mwedzi mitanhatu yega yega. Mushure memakore mashanu, kuongororwa kwegore negore kunokurudzirwa. Mazinga eAlpha-fetoprotein (AFP) anogona kushandiswa sechiratidzo chekudzoka kwegomarara. Kana kurapwa kwacho kukabudirira, gomarara racho richadzikira kana kunyangarika zvachose. Muzviitiko apo gomarara richiripo asi risina masero anoshanda, kungwarira kunofanira kuitwa kana gomarara rine dhayamita inopfuura 5cm richionekwa pamifananidzo, uye PET scans dzinogona kushandiswa kuti kujekeswe zvakanyanya.
Kuongororwa kwekiriniki kwemhedzisiro yekurapwa isati yatanga uye yapera, kusanganisira huwandu hwe alpha-fetoprotein, mashandiro echiropa, uye MRI scans,vakaratidza mwero wekurerukirwa kwechirwere ichi unopfuura 80% kune varwere vane kenza yechiropa vakarapwa neHIFU.Muzviitiko apo ropa rinosvika kumabundu echiropa akawanda, kurapwa kweHIFU kunogona kusanganiswa nekupindira kwe transarterial. HIFU isati yatanga kurapwa, transcatheter arterial chemoembolization (TACE) inogona kuitwa kudzivirira ropa kusvika kunzvimbo yebundu iri pakati, ne embolic agent inoshanda sechiratidzo chebundu kubatsira pakutarisa HIFU. Oiri yeIodine inochinja acoustic impedance uye absorption coefficient mukati mebundu, zvichiita kuti simba rishandurwe panzvimbo yeHIFU uye kunatsiridza..
Nguva yekutumira: Nyamavhuvhu-08-2023